Japanese Medical Literature Research Articles

The earliest description of an ugly woman in Japanese medical literature

The earliest description of an ugly woman in Japanese medical literature

Current Status of Chinese Medicine Nursing in Japan: A Narrative Literature Review

In Japan, education in Chinese medicine nursing is not officially recognized, but the knowledge, techniques, and ideas of Chinese medicine nursing are considered to be an essential area of modern nursing. The purpose of this study was to clarify the current state of Chinese medicine nursing in Japan through a narrative review of Japanese literature. Using Ichushi-Web, a Japanese medical literature database, a search was conducted for original articles using the keyword “Chinese medicine nursing,” yielded 50 hits. All literature was collected and carefully read, and seven articles on Chinese medicine nursing in Japan were narratively reviewed. Of these, three articles concerned education in Chinese medicine nursing and four related to research. In terms of education, the educational effects of Chinese medicine nursing, which was introduced on a trial basis, were observed, but the trustworthiness of the evaluation of its outcomes was unclear. One issue was securing of educators for Chinese medicine nursing. In terms of research, Chinese medicine nursing was practiced for palliative care patients, outpatients with insomnia, and expectant mothers, but the trustworthiness of the evaluation of its outcomes was unclear. Certified Nurse Specialists in Japan are expected to combine cure and care in their practice, and application of Chinese medicine nursing is feasible. In the future, it will be necessary to propagate Chinese medicine nursing, which takes into account the constitution of the patient and emphasizes the patient’s natural healing powers.

Methods to Enhance Accessibility of Japanese Medical Literature in English Journals

Methods to Enhance Accessibility of Japanese Medical Literature in English Journals

Barriers to the Utilization of Low-Vision Rehabilitation Services among Over-50-Year-Old People in East and Southeast Asian Regions: A Scoping Review.

East and Southeast Asia (ESEA) are facing age-related eye health issues. Low-vision rehabilitation (LVR), which is a special rehabilitation service for individuals with vision impairment, is a promising solution for these health issues; however, poor accessibility to LVR services has been reported globally, including ESEA. Therefore, this scoping review aimed to summarize and understand the barriers to accessing LVR services in ESEA. In total, 20 articles were ultimately considered eligible for this scoping review after an electronic database search using MEDLINE (PubMed), Web of Science, Academic Search Ultimate (EBSCO), and Ichushi-Web (Japanese medical literature database), and an independent review by two reviewers. Twenty-one potential barrier factors were identified in the full-text review. Notably, age, education, economic status, "previous experience using eye care service", and "knowledge, information, and awareness" were the possible barrier factors that were examined for their association with LVR utilization, with supportive evidence in many eligible studies. We also identified research gaps relating to geographical and ethnic diversity, the scope of LVR services, and barriers among eligible articles. Therefore, by conducting further studies addressing the research gaps identified in this scoping review, these findings can be used to make LVR services more accessible to people in ESEA.

Foreign Patients Visiting the Emergency Department: A Systematic Review of Studies in Japan.

As the number of non-native patients in Japan is increasing, emergency departments must provide proper care for international patients. However, no research has been conducted to determine the demographics of international patients that visit Japanese hospitals or the requirements to accept them. We aimed to organize the existing research and its patterns for foreign patients in Japan's emergency departments and to identify the areas that require further research. Systematic review of research articles indexed in MEDLINE and Ichushi-web (Japanese medical literature) was conducted. The search strategy was based on a previous study in Japanese, and the search was limited to manuscripts published from 2015. Nine publications that reported on the demographic characteristics of foreign patients who visited the emergency department were among the study's 13 references. Injury diagnoses and the Asian population were both common. Dealing with overseas patients can be challenging due to linguistic barriers, cultural differences, and payment issues. However, studies describing the spoken language and the type of healthcare insurance used were lacking. Furthermore, neither the definition of "foreign patients" nor the distinction between short-term visitors and long-term residents were made in the majority of the research. The demographic characteristics of patients differed depending on the location and facility, despite the fact that several characteristics of foreign patients in emergency departments appeared to be generalizable. The COVID-19 pandemic may modify the demographic characteristics of immigrants; thus, more research from a broad range of locations and medical facilities is still necessary.

Challenges and the potential of promoting remote medical interpreting during COVID-19.

Language barriers negatively affect patient outcomes, and linguistic assistance is essential for adequate healthcare. The adoption of face-to-face medical interpretating is believed to have been rendered more challenging by the implementation of hospital admission restrictions following the outbreak of novel coronavirus disease (COVID-19). On the other hand, remote interpretating can be implemented using merely equipment, enabling it to be introduced without being impacted by the transmission of illness, and its use may have spread globally. To comprehend how COVID-19 has impacted remote interpreting utilization and what issues have arisen, we conducted a systematic review of two databases, PubMed and Ichushi-web (Japanese medical literature) with "remote interpreting" and "COVID-19" as keywords in June, 2022. Five references were included in the review. The research supported an increase in remote interpreting during COVID-19 to limit the risk of infection. This change in the trend of medical interpreting has the potential of promoting remote medical interpreting for places lacking sufficient linguistically skilled human resources, regardless of the pandemic status. There have also been accounts of novel methods of remote medical interpretation in which neither the healthcare professional nor the interpreter was face-to-face with the patient, and difficulty was acknowledged by both the healthcare professional and the patient with remote interpreting. To fully take advantage of the possibilities of remote interpreting, additional training and support would be required. Further studies are also required to determine the best way to employ this technology.

Japan perspective on antimicrobial stewardship and solid organ transplantation.

The current situation, challenges, and opportunities related to antimicrobial stewardship for solid organ transplantations (SOTs) patients in Japan are not well known. We searched English and Japanese literature using Pubmed and Ichushi-Web (the Japanese medical literature search system provided by the Japan Medical Abstract Society) with relevant keywords including solid organ transplant, antimicrobial stewardship, and Japan. Hand searches of the references from the retrieved literature, including conference proceedings of The Japanese Association for Infectious Diseases, were conducted. The Japanese National Action Plan for antimicrobial resistance has brought attention to the importance of antimicrobial stewardship programs (ASPs) in Japan. According to national surveillance, the proportion of methicillin resistance among Staphylococcus aureus was 48%, while the proportion of vancomycin-resistance among Enterococcus faecium was 1.5% in 2019. Resistance against imipenem in Escherichia coli and Klebsiella pneumoniae in 2019 were 0.1% and 0.2%, respectively. Exploration of SOT-specific data on antimicrobial usage and drug resistance are warranted. A large questionnaire survey revealed a low proportion of hospitals with >500 beds implementing ASP toward immunocompromised patients. While the annual number of SOT in Japan has increased, the implementation of SOT-specific ASP varies among institutions. A coordinated ASP and exploration of the burden of antimicrobial resistance are needed for SOT patients in Japan. Promoting both intrainstitutional and interinstitutional collaboration is vital to the advancement of SOT-specific ASP in Japan.

465 - Research trends in simulated education in gerontological nursing by text mining analysis

AbstractPurposeThe present study aimed to reveal trends in simulated education in Japanese gerontological nursing by conducting a text mining analysis of the Igaku Chuo Zasshi databank.MethodsSimulated education is focused by field of Japanese nursing education in recently. Therefore, we searched for original articles containing the terms “Simulated education” and “gerontological nursing” which were published between 2014and 2019. Articles containing these terms, as well as thesaurus words in the articles, were analyzed using Trend Search. The analysis provided a conceptual map of related words, with the strength of the relationship reflected in the thickness of lines and the distance between them.Igaku Chuo ZasshiA literature search was conducted using Igaku Chuo Zasshi, the Japanese medical literature database provided by the NPO Japan Medical Abstracts Society. This database comprises approximately 5000 journal titles and 6,300,000 articles.Text mining softwareTrend Search is a commercially available software developed by FUJITSU. Articles were anonymized prior to analysis.Ethical considerationsOnly anonymous articles were selected.Results and ConclusionsThe search identified 15 articles. Mapping yielded the two wedges of [Learning] and [Simulated game]. The [Learning] wedge had three groups ( Introduce, Communications, and Aging ). Introduce refers to nursing processes via simulated patients or role play. Communications refers to practice in gerontological nursing. Aging refers to role playing with group works in fundamental nursing. The [Simulated game] wedge had two groups (Effects and On-the-job training). Effects refers to leaving bed or psychographics. On-the-job training refers to simulation of elderly because of understanding.

PHP59 - Studies on Economic Burden of Disease Using Real-World Healthcare Data in Japan: A Systematic Review

Real-world evidence has gained importance in healthcare decision making and the development of health policy globally. This study aimed to identify studies using real-world data to estimate economic burden of disease in Japan. A systematic review was conducted to identify potentially relevant publications. PubMed/EMBASE and ICHUSHI, a Japanese medical literature database, were searched for studies published between February 2012 and February 2018. Studies of interest were those using Japanese healthcare claims database as the study data source, and the outcome of interest was healthcare costs and resource utilization. Clinical trial, case reports and chart review studies were excluded. Two reviewers assessed the studies against inclusion/exclusion criteria, with results reported based on PRISMA guidelines. This review identified 51 literature using Japanese healthcare claims database to estimate the economic burden of disease. Cancer (9; 18%) and cardiovascular (8; 16%) disease were two most commonly reported disease areas. The diagnosis procedure combination (DPC) claims database was used in 82% of the studies, whereas 18% used health insurance payer claims database. Length of stay and inpatient medical cost were commonly used to evaluate the economic burden of disease. Furthermore 16% of the studies focused on the cost impact of specific medications, while 47% focused on the financial burden of certain health conditions. According to Ministry of Health, Labour and Welfare in Japan, the sustainability of Japanese healthcare system is foreseen to be financially challenged due to the super-aging society, where proper distribution of healthcare costs and resource utilization become important. Claims database has a great amount of data, and is able to capture the real-world clinical patterns in multiple institutions. More claims database studies are needed to enrich the evidence on economic analysis of diseases, and to demonstrate the value of health technology.

Clinical practice guideline for post-ERCP pancreatitis.

Endoscopic retrograde cholangiopancreatography (ERPC) is used for the diagnosis and treatment of pancreatic and biliary diseases. Post-ERCP pancreatitis (PEP) is a complication which needs special care and clinical practice guideline for this morbidity is also needed. The key clinical issues of diagnosis and treatment of PEP were listed and checked, and then the clinical questions were formulated. PubMed (MEDLINE) and Ichushi-web (Japanese medical literature) were used as databases. For the study of diagnostic test accuracy, items similar to QUADAS-2, i.e., random selection from a population to which the diagnostic test is applied, blinding of index tests and reference tests, completeness of reference standard, completeness of test implementations, the same timing of tests, and missing data were assessed as well as the indirectness of the study subjects, index tests, reference standard, and outcomes. Grading of recommendations was determined as strong or weak. In clinical practice, the judgment of attending doctors should be more important than recommendations described in clinical practice guidelines. Gastroenterologists are the target users of this clinical practice guideline. General practitioners or general citizens are not supposed to use this guideline. The guideline committee has decided to include wide clinical issues such as etiological information, techniques of ERCP, the diagnosis, treatments, and monitoring of PEP in this guideline. In this concise report, we described ten clinical questions, recommendations, and explanations pertaining to risk factors, diagnosis, prognostic factors, treatments, and preventive interventions in the medical practice for PEP. We reported here the essence of the clinical practice guideline for PEP.

Necrobiosis Lipoidica in the Absence of Diabetes Mellitus: A Case Report and an Analysis of 116 Japanese Cases

A 60-year-old Japanese woman was referred to our hospital for yellow-brown plaques accompanied by ulceration on her left lower leg. Her medical history included neither diabetes mellitus nor minor trauma. A histopathological examination of the plaques showed necrobiotic changes within the dermal collagen surrounded by granulomas that comprised lymphocytes, histiocytes, and giant cells. The lower dermis revealed fibrotic changes that extended into the subcutaneous tissue. The patient’s blood glucose and glycated hemoglobin levels were within the normal ranges. We considered a diagnosis of necrobiosis lipoidica (NL) in the absence of diabetes mellitus. We reviewed 116 cases of NL that were reported in the Japanese medical literature between 1986 and 2014 and found that NL onset was most common in individuals of both sexes ≥ 60 years of age. Previous reports that reviewed NL cases in the Japanese medical literature that were published during the1900s indicated that NL occurs in people ≥ 40 years of age. We suggest that the aging population and increasingly longer life spans have increased the average age of NL onset in Japan. With regard to treatments, there were no effective treatments, but skin grafts were curative. NL treatment is very difficult, especially when ulcers are present; hence, we suggest that further research is needed to determine effective NL treatments.

Broken Heart Syndrome (Takotsubo Cardiomyopathy) Triggered by Acute Mania: A Review and Case Report

Throughout the centuries and in various cultures, authors have described a relationship between emotional states and heart functioning, colloquially called a “broken heart.” Similarly, the medical literature is filled with reports of stress-induced cardiac disorders, including sudden cardiac death. Initially called “human stress cardiomyopathy syndrome,” the phenomenon was first described by doctors reporting “extensive myocardial contraction band necrosis” found in a series of murder victims who had been emotionally and physically traumatized prior to their deaths. Pathology reports described the myocardial damage to have been “comparable to lesions described in stressed animal experiments” and suggested that their findings were “strongly supportive of the theory of catecholamine mediation of these myocardial changes in man and of the lethal potential of stress through its effect on the heart.” Over the years, the medical nomenclature has changed and the condition has been called by many names, including “broken heart syndrome,” “human stress cardiomyopathy syndrome,” “left ventricular apical ballooning syndrome,” “ampulla cardiomyopathy,” “transient left ventricular dysfunction,” “transient left ventricular (LV) apical ballooning syndrome,” “stress cardiomyopathy,” “apical ballooning syndrome,” and finally “Takotsubo cardiomyopathy.” The name Takotsubo cardiomyopathy (TTC) was first used in the Japanese medical literature to describe the appearance on left ventriculography, which reveals a rounded hypokinetic apex with a narrow hypercontracted base resembling a pot previously used in Japan to catch octopus (in Japanese “tako” means octopus and “tsubo” means pot). TTC is a cardiac syndrome characterized by transient LV dysfunction (typically in the above pattern), electrocardiographic changes that can mimic acute myocardial infarction (MI), and a low-level release of myocardial enzymes in the absence of obstructive coronary artery disease (CAD).

Nephrogenic systemic fibrosis: risk factors suggested from Japanese published cases

The aim of this article is to review the published cases of nephrogenic systemic fibrosis (NSF) in Japan. The Japanese medical literature database and MedLine were searched using the keywords NSF and nephrogenic fibrosing dermopathy (January 2000 to March 2009). Reports in peer-reviewed journals and meeting abstracts were included, and cases with biopsy confirmation were selected. 14 biopsy-verified NSF cases were found. In seven of eight patients reported after the association between gadolinium-based contrast agent (GBCA) and NSF was proposed, GBCA administration was documented: five received only gadodiamide; two received both gadodiamide and gadopentetate dimeglumine. In four cases, the amounts of contrast agent were registered: two received only a single dose (0.1 mmol kg(-1) body weight) whereas the other two received 7-15 ml (the body weight was not disclosed) for each MR examination. Five patients had multiple injections of GBCA before NSF developed. Except for one patient in whom renal assessment was not reported, none of the patients had an estimated glomerular filtration rate >30 ml min(-1) 1.73 m(-2) and all received dialysis. 5 of the 8 patients (63%) in whom GBCA exposure was confirmed were treated with peritoneal dialysis. Skin lesion of the lower extremity was the first symptom in 12 patients (86%), whereas 2 patients had primarily symptoms from the upper extremity. In three cases, GBCA was administered even after onset of the NSF symptoms because of the physicians' lack of knowledge about the possible association between GBCA and NSF. NSF is found among Japanese end-stage renal failure patients even after examinations using a single dose.

Prognostic value of myocardial metabolic imaging with BMIPP in the spectrum of coronary artery disease: A systematic review

BackgroundWe conducted a systematic review to summarize the current literature on the prognostic value of BMIPP imaging, fatty-acid metabolic imaging, for the prediction of cardiovascular events in coronary artery disease. Methods and ResultsElectronic databases (including Japanese medical literature search engines) were searched by a Japanese investigator using a predefined search strategy. Eleven studies, all conducted in Japan, were included in the meta-analysis. In three studies involving 541 patients with suspected acute coronary syndrome who were excluded for acute myocardial infarction (AMI), an abnormal finding on BMIPP imaging was significantly associated with future hard events (cardiac death or non-fatal myocardial infarction). The negative predictive value of BMIPP imaging for future hard events was 98.9% (96.8-99.7%) over 3.5 years. In six studies involving 542 patients with AMI, a larger defect on BMIPP imaging was significantly associated with future hard events. The prognostic value of perfusion-metabolism mismatch compared with myocardial perfusion imaging was dependent upon the relative timing of BMIPP imaging, revascularization, and myocardial perfusion damage. ConclusionsBMIPP imaging is useful for the risk stratification of patients with coronary artery disease, particularly patients with acute chest pain.

SELF‐EXPANDABLE METALLIC STENT FOR PATIENTS WITH NON‐RESECTABLE MALIGNANT COLORECTAL STRICTURE: REVIEW OF 102 CASES IN THE JAPANESE LITERATURE

Alternative procedures using endoscopy have been developed, one of which is treatment with self‐expandable metallic stents (SEMS). In Japan, as SEMS for colorectal stricture has not been approved by the public insurance system, esophageal stent is used for colon and rectum exceptionally as a colonic SEMS after obtaining informed consent from the patient. This situation is very different to other countries. In the present study, we review the Japanese medical literature to determine the current status, feasibility, and challenges remaining for SEMS to show the current status of SEMS usage for colonic strictures in Japan. We investigated SEMS for patients with non‐resectable malignant colorectal stricture in 102 Japanese case reports. Primary colorectal cancer comprised half of the cases. The insertion success rate was 100% and the clinical effectiveness rate was 93%. Restricture occurred in 12 cases (12%), and half of those cases were treated by stent in stent. Stent migration occurred in eight cases (8%) and perforation in two cases (2%). The range of SEMS insertion duration was 1 to 576 days (mean: 132 days, median 142 days). There were no deaths related to the procedure. This procedure allows patients to forgo colostomy and is cheap, safe and effective, with a short treatment time. This procedure is a viable palliative alternative to colostomy for patients with inoperative malignant colorectal stricture. Widespread application of the procedure has been hampered.

Spontaneous remission of spasms in West syndrome – implications of viral infection

On a database of the Japanese medical literature between 1970 and 2000, there were 29 patients with West syndrome showing spontaneous remission. In 25/29 (86%) of the patients, spontaneous remission was preceded by viral infections, among which exanthema subitum predominated. In 16/29 (55%), the spasms recurred a median of 2 months later. However, some of the remaining infants attained lasting remission of the spasms. This link between viral infections and spontaneous remission suggests immuno-inflammatory processes underlie West syndrome in certain patients. Better understanding of such mechanisms may lead to a new therapeutic approach to West syndrome.

黄色肉芽腫性精巣上体炎の1例

A 45-year-old man with spinal injury and diabetes mellitus who complained high fever and progressive enlargement of left intrascrotal mass visited to our hospital. Preoperative ultrasonography demonstrated epididymitis and abscess formation. Left high orchiectomy was performed because testicular tumor could not be denied. Epididymis was replaces by bright yellow mass associated with abscess and adhered to testis strongly. Histopathologically, the mass diagnosed xanthogranulomatous epididymitis consisted of foamy macrophages and chronic inflammatory cells. This is the first case in Japanese medical literature.

Renal Cell Carcinoma of Extraordinarily Large Size: A Case Report

One of our patients was a 66-year-old woman with a T2 renal cell carcinoma weighing 3900 g. Two years after radical nephrectomy the woman was alive and well. A survey of Japanese medical literature revealed that patients with renal cell carcinomas weighing more than 2000 g have an unexpectedly favorable prognosis with a 5-year survival rate of 76.9%.

Clinical features of pneumonitis induced by herbal drugs

The aim of this study was to call attention to interstitial pneumonitis as an adverse effect of herbal drugs. Twenty-four cases (22 patients) with herbal drug-induced pneumonitis were reviewed based on the Japanese medical literature. Eight types of herbal drugs were reported as causative agents, and 15 of the 24 cases were due to Sho-Saiko-to. On chest x-ray films, one patient with bronchial asthma showed a pattern of pulmonary infiltration with eosinophilia (PIE syndrome) and the others a diffuse interstitial pneumonitis. The duration of herbal drug intake was variable from a period of one day to several months. Major clinical symptoms were dyspnoea, cough and fever, and the laboratory data showed hypoxaemia and positive inflammatory reactions with increased WBC and raised ESR and CRP. Results of bronchoalveolar lavage (BAL) showed an increased lymphocyte or neutrophil population and a low OKT4/OKT8 ratio. The in vitro lymphocyte stimulation test (LST) was positive in 74% (17/23) of cases and the in vivo challenge test 100% (10/10). In conclusion, we should be attentive to adverse effects such as interstitial pneumonitis when we treat patients with herbal drugs. © 1997 John Wiley & Sons, Ltd.

Prevalence of diabetes mellitus in Japan compiled from literature

This is an excerpt from the report (1992) of the Epidemiology Data Committee of the Japan Diabetes Society. Portions reading the community-based prevalence data on adult diabetes and the data of official sources are shown. Data on the prevalence and incidence of diabetes were collected from Japanese medical literature from 1959–1991 by various means. In early studies, people were first screened by urine glucose test, and subjects positive for glucosuria were further evaluated by blood glucose test. Recent studies mostly used 75 g GTT without prior urine screening. Before 1984, the criteria of the JDS (1970) were chiefly used, while after 1985 the WHO criteria are used to define diabetes. Prevalence of diabetes in people older than 40 years was 1.3–4.7% in earlier studies, but it increased to 4–11% in recent studies despite the fact that the WHO criteria are more stringent in defining diabetes than the JDS criteria of 1970. The prevalence of diabetes was higher in men than in women in most reports. Some publications from the Ministry of Health and Welfare included the data on diabetes. They were based on the information of known diabetic patients seen by doctors, and gave much lower estimates of prevalence than community-based surveys. The estimated prevalence of diabetes was 1.7% from the 1987 Patient Survey and 1.1% by the Comprehensive Survey of Living Conditions. There was a sharp 30-fold increase during these 30 years. Efforts are now being made to collect more accurate data on the prevalence of diabetes in Japan by the Epidemiology Study Group sponsored by the Ministry of Health and Welfare.